Homestead_Lowe INDIANA SALES DISCLOSURE FORM SDF ID:
Page 2
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Rexanne McCauley Title& Escrow Processing
Preparer of the Sales Disclosure Form Title
3930 Mezzanine Drive, Ste C Columbia Title. Inc.
Address(Number and Street) Company
Lafayette, IN 47905
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_E�.SELLER(S�%GRAN,TOR(S)t� .� ± �'�_ Is _ a.' -Ye . _ _ _ •.:•'°a:a4b4r - 's�'_ -,},T•-.1 'v. ' .s moo. _.n'- -?
I Larry L Basham
Seller 1'Name as appears on conveyance document Seller 2-Name as appears on conveyance document
103 York Lane
Address(Number and Street) Address(Number and Street)
Part icah Kentucky 4200-3
City,State,and ZIP Code City,State,and ZIP Code
E-mail Telephone Number E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and co as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Sig Cure ofSeller�`( Signature of Seller
I arty I Rasham 5/20/2019
Printed Name o Seller Sian Date MM/D0/1 Printed Name o Seller Si :e
r :BU • h';TEE(S) APPLICATION,FOR'.PROP,ERTeY_TAX DEDUCTIONS=IDENTIFY.ALI ]TEMS. T ,L i, _- _ ______
David J. Lowe
BuyerI Vame as au. ,an conveyance document Buyer Name as appears on conveyance domment�UN 0 3 2019
ee
Address(Number and Street) Address(Number and Street)
State,and ZIPcode
Princeton. IN 47670
City, �City,State,and ZIPcode cityGIBSON COUNTY AUDITOR
E-mail Telephone Number E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FORTH RTY. IDENTIFY: SE THAT APPLY.
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3.Homestead
residence? Provide complete address of prima , I . g/Cooling System
residence, including county:
802 Fast State Street ❑ ❑✓ S.Wind Power Device
Address(Number and Street) ❑ M 6. Hydroelectric Power Device
Princeton. IN 47670 Gibson ❑ ❑ 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ N 2. Does the buyer have a homestead in Indiana to be ❑ ❑✓ 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 1A 9.Would you like to receive tax statements for this
complete address of residence being vacated, • -•- I via e-mal . - .•': .ntact information
including county: below.Please see instructions for mo - '• ormation.
Not available in all counties.)
Address(Number and Street)
City,State ZIP code �LA.1 .° g -1,03 -002. Le --02g •
County
admvy property owner contact name E-mail
Number License/ID/Other Number